Health secretary Sajid Javid has promised an overhaul of NHS leadership following a review that found ‘institutional inadequacy’ in the way NHS leadership and management is trained, developed and valued.
The review, by General Sir Gordon Messenger and Dame Linda Pollard, looked at leadership and management across primary care as well as secondary and social care levels.
It hoped ‘to avoid a disproportionate focus on secondary care’ and made recommendations that are of relevance across the sectors, according to the review’s authors.
However, Matthew Taylor, chief executive of NHS Confederation, has said the review had ‘limited focus’ on primary care and social care, and that it risks these sectors looking like ‘an after-thought’.
Over 1,000 stakeholders across the NHS were interviewed for the review, including GPs, managers, allied health professionals and patients.
The authors made seven recommendations to try and improve the culture, equality, development and value placed on leaders within the NHS structure. These include a commitment to improve diversity, equality and inclusion, accredited training, a more effective appraisal system and clearer progression routes.
The review said: ‘We strongly believe our recommendations should transform health and social care leadership and management and drive the cultural and structural changes necessary to future-proof it.
‘But we also recognise that previous reviews have reached equally sensible conclusions but have failed to have the impact they deserve.’
The authors recommended several steps to avoid this happening again, including making the participation in the training and development areas mandatory.
Mr Javid said the findings of the report were ‘stark’, but that he will ‘fully support’ the recommendations and will ‘urgently’ take them forward.
Mr Taylor, at NHS Confederation, said it was an important report, despite his criticism of the lack of primary care inclusion.
‘While there may be a view in some quarters that money spent on NHS managers is wasted, we know that high performing health systems require investment in effective management,’ he said.
‘We need to move away from the damaging narrative that managers are somehow an unnecessary expense. Put simply, our NHS is not over-managed and never has been.’
Earlier this year, practice managers criticised alleged plans to bring general practices under control of hospital trust leadership, saying it would not improve workforce morale or patient care.